Special Report - The World Health Organization's Critical Challenge: Healing Itself

When executive board members of the World Health Organization sat down for their annual meeting in Geneva in January, many powerful figures spoke forcefully of the need to reform the leading global authority on health and disease. "It's time to stop talking," Stewart Jessamine, New Zealand's director of public health and a WHO executive board member, told the delegates. "We have to change." Jimmy Kolker, a leading member of the U.S. delegation, told the meeting the WHO must "recognise how crucial this moment is for the future of the organisation, and the resources and the trust that are in the balance."

For years the WHO has talked about streamlining its complex structure, governance and financing to make it more efficient. Critics say the organisation needs deep reforms to allow it to show clear leadership in promoting health and to respond decisively to disease emergencies that may span many countries. But progress has been painfully slow. Margaret Chan, Director General of the WHO since 2007, acknowledged the concerns of delegates and agreed with Jessamine: "Yes, it’s time to stop talking," she said. She promised to act swiftly on reforming the WHO’s emergency responses. "We are committed to implementing a single programme, with a single line of accountability, a single budget, a single set of business processes, a single cadre of staff and a single set of performance benchmarks," she said.

The pressure for change has been building after a series of missteps by the global health body. Last year, while still smarting from accusations it overreacted to the 2009-10 H1N1 flu pandemic, the WHO faced withering criticism for not reacting fast enough to the Ebola crisis in West Africa. The organisation's Lyon-based International Agency for Research on Cancer (IARC) has become a target of ridicule among some health experts for issuing confusing warnings on everything from the air we breathe to the meat we eat to the phones we use. And the WHO is now being questioned about its response to the Zika virus...